Effects of minute oscillation stretching training on muscle and tendon stiffness and walking capability in people with type 2 diabetes.

Aim: we investigated the effects of a 10 week training program (i.e., minute oscillatory stretching; MOS) on the mechanical responses and walking capability in people with type 2 diabetes (T2D).

Methods: seventeen T2D patients performed maximum voluntary contractions of the plantar flexor muscles during which Achilles tendon stiffness (k_T) and muscle-tendon stiffness (k_M) were evaluated at different percentages of the maximum voluntary force (MVC). In addition, each participant was requested to walk at different walking speeds (i.e. 2, 3, 4, 5, and 6 kmh^-1) while their net energy cost of walking (C_net), cumulative EMG activity per distance travelled (CMAPD) and kinematic parameters (step length, step frequency, the ankle/knee range of motion) were evaluated.

Results: maximum tendon elongation increased after MOS training, and k_T significantly decreased (between 0 and 20% of MVC). No differences were observed for muscle elongation or k_M after training. C_net decreased after training (at the slowest tested speeds) while no changes in CMAPD were observed. Step length and ankle ROM during walking increased after training at the slowest tested speeds, while step frequency decreased; no significant effects were observed for knee ROM.

Conclusion: these results indicate the effectiveness of 10 weeks of MOS training in reducing tendon stiffness and the energy cost during walking in people with T2D. This training protocol requires no specific instrumentation, can be easily performed at home, and has a high adherence (92 ± 9%). It could, thus, be useful to mitigate mechanical tendon deterioration and improve physical behaviour in this population.